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Oklahoma Immunization Update
February 2014
PREVENTION and PREPAREDNESS SERVICES
IMMUNIZATION SERVICE
PLEASE POST & DISTRIBUTE TO ALL NURSING AND MEDICAL STAFF
Sign Up to Receive this Update by E-Mail (You receive a better copy and everyone can subscribe):
Subscribe at: https://public.govdelivery.com/accounts/OKSDH/subscriber/new?topic_id=OKSDH_79.
All interested staff may subscribe, as there is no limit to the number of subscribers. You may cancel your subscription at any time.
Oklahoma’s Childhood Immunization Rates
Alarmingly Low
Oklahoma ranks 48th among the states for the percent
of children up-to-date with the primary series of
vaccines. Only 61% of Oklahoma toddlers 19 through
35 months of age have completed the entire series of 4
doses of DTaP, 3 doses of polio, 1 dose of MMR, 3 or 4
doses of Hib depending on the brand used, 3 doses of
HepB, 1 dose of varicella and 4 doses of PCV as
reported by the 2012 National Immunization Survey
(http://www.cdc.gov/vaccines/stats-surv/
nis/default.htm#nis). The 2020 Healthy People
Goal for the series is 80% coverage.
The individual vaccines with the lowest levels of
completion by 19-35 months of age in Oklahoma are
Hib, PCV, and DTaP.
Oklahoma Rate U.S. Rate
Hib 71.1 ± 7.5 80.9 ±1.2
4 PCV 76.4 ±6.7 81.9 ±1.1
4 DTaP 79.1 ±6.0 82.5 ±1.2
Full series Hib: ≥3 or ≥4 doses of Hib vaccine depending on
product type received (includes primary series plus the booster
dose).
The 2020 Healthy People Goal for each of these
individual vaccines is 90% coverage
Methods to increase the levels of Hib, PCV, and the
4th DTaP
1. Know Your Practice’s Vaccine Coverage Levels.
Find out the coverage rates for your practice and
track them over time. Contact your Immunization
Field Consultant to find out about your levels.
2. Plan a Clinic Intervention to Raise Levels
Consider the following strategies to increase
coverage rates.
· Reduce Missed Opportunities to Vaccinate.
Give all due or overdue vaccines at the same visit.
For example, the 3rd or 4th Hib, the 4th PCV and the
1st MMR are all recommended at 12 through 15
months of age. Oklahoma’s level for the 1st MMR is
90.0% (±4.8), if Hib and PCV were administered at
the same visit as the 1st MMR we would expect rates
for Hib and PCV to increase to the same level as
MMR.
Remember one in every four children is not
receiving the final doses of Hib and PCV on time.
· Target the 4th DTaP
The 4th DTaP has historically been the dose most
likely to be missed.
· Give the 3rd DTaP on time. Research shows
that children who get the 3rd dose on time are
more likely to get the 4th dose on time.
· Consider administering the 4th DTaP as early
as 12 months if there is any chance the child
will not return on schedule. According to the
recommended immunization schedule the 4th
dose may be administered as early as age 12
months, provided at least 6 months have
elapsed since the third dose.
· If you don’t want to administer DTaP at 12
months of age, pre-schedule 4th DTaP
appointments for 15 months of age.
Remember one in five children do not get the 4th
DTaP on time.
· Use the Catch-up Schedule
Children who are behind in the schedule should be
placed on the Catch-up or accelerated schedule.
The Catch-up schedule simply applies the minimum
recommended intervals to all the vaccines that are
overdue until the child is back on schedule. For a
list of the minimum intervals refer to this web page:
http://www.cdc.gov/vaccines/pubs/pinkbook/downloa
ds/appendices/A/age-interval-table.pdf. This table is
also available in the Pink Book, Appendix A:
Schedules and Recommendations.
Remember: Current antibiotic therapy is not a
contraindication to vaccination.
Vaccine Providers – Order this Booklet for Parents
This booklet backs up your answers. This 64-page
booklet offers easy to understand information on
vaccine-preventable diseases, vaccines, and safety
questions including mercury and aluminum. Provide this
booklet to all parents. Send an e-mail with the number of
booklets needed, your clinic name, and shipping address
to susanm@health.ok.gov. Quantities are not limited.
The Centers for Disease
Control and Prevention (CDC),
booklet, Parent’s Guide to
Childhood Immunizations is
available for ordering from the
Immunization Service at no
charge to you. Let parents
know it is OK to ask questions.
For an online version of this Update, visit the Immunization Service web page at:
http://www.ok.gov/health/Disease,_Prevention,_Preparedness/Immunizations/Vaccines_for_Children_Program/index.html

Oklahoma Immunization Update
February 2014
PREVENTION and PREPAREDNESS SERVICES
IMMUNIZATION SERVICE
PLEASE POST & DISTRIBUTE TO ALL NURSING AND MEDICAL STAFF
Sign Up to Receive this Update by E-Mail (You receive a better copy and everyone can subscribe):
Subscribe at: https://public.govdelivery.com/accounts/OKSDH/subscriber/new?topic_id=OKSDH_79.
All interested staff may subscribe, as there is no limit to the number of subscribers. You may cancel your subscription at any time.
Oklahoma’s Childhood Immunization Rates
Alarmingly Low
Oklahoma ranks 48th among the states for the percent
of children up-to-date with the primary series of
vaccines. Only 61% of Oklahoma toddlers 19 through
35 months of age have completed the entire series of 4
doses of DTaP, 3 doses of polio, 1 dose of MMR, 3 or 4
doses of Hib depending on the brand used, 3 doses of
HepB, 1 dose of varicella and 4 doses of PCV as
reported by the 2012 National Immunization Survey
(http://www.cdc.gov/vaccines/stats-surv/
nis/default.htm#nis). The 2020 Healthy People
Goal for the series is 80% coverage.
The individual vaccines with the lowest levels of
completion by 19-35 months of age in Oklahoma are
Hib, PCV, and DTaP.
Oklahoma Rate U.S. Rate
Hib 71.1 ± 7.5 80.9 ±1.2
4 PCV 76.4 ±6.7 81.9 ±1.1
4 DTaP 79.1 ±6.0 82.5 ±1.2
Full series Hib: ≥3 or ≥4 doses of Hib vaccine depending on
product type received (includes primary series plus the booster
dose).
The 2020 Healthy People Goal for each of these
individual vaccines is 90% coverage
Methods to increase the levels of Hib, PCV, and the
4th DTaP
1. Know Your Practice’s Vaccine Coverage Levels.
Find out the coverage rates for your practice and
track them over time. Contact your Immunization
Field Consultant to find out about your levels.
2. Plan a Clinic Intervention to Raise Levels
Consider the following strategies to increase
coverage rates.
· Reduce Missed Opportunities to Vaccinate.
Give all due or overdue vaccines at the same visit.
For example, the 3rd or 4th Hib, the 4th PCV and the
1st MMR are all recommended at 12 through 15
months of age. Oklahoma’s level for the 1st MMR is
90.0% (±4.8), if Hib and PCV were administered at
the same visit as the 1st MMR we would expect rates
for Hib and PCV to increase to the same level as
MMR.
Remember one in every four children is not
receiving the final doses of Hib and PCV on time.
· Target the 4th DTaP
The 4th DTaP has historically been the dose most
likely to be missed.
· Give the 3rd DTaP on time. Research shows
that children who get the 3rd dose on time are
more likely to get the 4th dose on time.
· Consider administering the 4th DTaP as early
as 12 months if there is any chance the child
will not return on schedule. According to the
recommended immunization schedule the 4th
dose may be administered as early as age 12
months, provided at least 6 months have
elapsed since the third dose.
· If you don’t want to administer DTaP at 12
months of age, pre-schedule 4th DTaP
appointments for 15 months of age.
Remember one in five children do not get the 4th
DTaP on time.
· Use the Catch-up Schedule
Children who are behind in the schedule should be
placed on the Catch-up or accelerated schedule.
The Catch-up schedule simply applies the minimum
recommended intervals to all the vaccines that are
overdue until the child is back on schedule. For a
list of the minimum intervals refer to this web page:
http://www.cdc.gov/vaccines/pubs/pinkbook/downloa
ds/appendices/A/age-interval-table.pdf. This table is
also available in the Pink Book, Appendix A:
Schedules and Recommendations.
Remember: Current antibiotic therapy is not a
contraindication to vaccination.
Vaccine Providers – Order this Booklet for Parents
This booklet backs up your answers. This 64-page
booklet offers easy to understand information on
vaccine-preventable diseases, vaccines, and safety
questions including mercury and aluminum. Provide this
booklet to all parents. Send an e-mail with the number of
booklets needed, your clinic name, and shipping address
to susanm@health.ok.gov. Quantities are not limited.
The Centers for Disease
Control and Prevention (CDC),
booklet, Parent’s Guide to
Childhood Immunizations is
available for ordering from the
Immunization Service at no
charge to you. Let parents
know it is OK to ask questions.
For an online version of this Update, visit the Immunization Service web page at:
http://www.ok.gov/health/Disease,_Prevention,_Preparedness/Immunizations/Vaccines_for_Children_Program/index.html